In Code Green: Money-Driven Hospitals and the Dismantling of Nursing, sociologist Dana Beth Weinberg analyzes the change in nursing culture at Beth Israel Deaconess Medical Center (BIDMC), Boston, Mass. Weinberg researched the hospital from January to September 1999, shadowing six medical-surgical nursing units during the merger of Beth Israel and The New England Deaconess Hospital. Her intensive research included attending staff meetings, interviewing nurses and administrators, holding nurse focus groups, conducting surveys, and scrutinizing internal hospital documents. In her book's second chapter, Weinberg places BIDMC's nursing environment in the context of other hospital industry changes, namely, the prevalence of hospital restructuring.
Areas for change
In the book's following chapters, Weinberg discusses how BIDMC's merger altered the patient care models nurses used, how the model change resulted in the dismantling of the nursing department, and the effects of power conflicts or nurses' ability to provide quality patient care. Chapter six focuses on physician/nurse relationships, and chapter seven discusses nurses' perceptions regarding the amount of time they had, per patient, to provide care. Weinberg examines the debate between nurses and administrators at BIDMC over whether the restructuring compromised patient care. The last chapter evaluates the strategies for restructuring that BIDMC used, how it affected nurses, and the implications for nursing's future.
According to Weinberg, BIDMC experienced a code green-a financial, nursing, and patient care emergency-from which it's still recovering. By examining the specific aspects of the code green, Weinberg provides an example of how operating as a money-driven hospital damages a nursing workforce and contributes to the shortage.
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